17D-028 (4) PERMIT APPLICATION CHECK LIST
PAGE PLOT d-O ZONE �L YES DATE
ZONING APPLICATION 311(al g5i,
2 . PERMIT—APPLICATION
�-"
3 . OW IF NO
3 SE pLAN
NEW CONSTRUCTION
Q . CURB CUT
7 WATER
8 . - REMODELING INTEgIog
9 . ADDI I
10 . ACCESSORY STRUCTURE
11 , SIGN / AWNING
2 . PERMIT FEE - C - MONEY OSDER v
13 . -SPECIAL E REQUIRED WITH DEED 'IF APPLICABLE
14 . UNDER SECTION - C R 780
15 . FORM
j6 . FILL
COMMENTS :
i
i
a
a
T
Oil
inZ
> cn O
^� rrnn �
Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
`j Garage
1. Location r! v Lot No.
2. Owner's name Address s
3. Builder's name Address
Mass.Construction Supervisor's License No. 6 14eli /A- Expiration Date
4. Addition
5. Alteration
6. New Porch
7. Is existing building to be demolished?
8. Repair after the fire
9. Garage No.of cars Size
10. Method of heating
11. Distance to lot lines
12. Type of roof
13. Siding house
14. Estimated cost:-
o24DD. =
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
Signature of responsible appicani
Remarks'
� „ 3ql q
Date Filed �So `j File No.
ZONING PERMIT APPLICATION
Name of Applicant:
Address: Telephone:
�. owner of Property:_
Address: (� 3 Telephone:
3 . Status of Applicant: Owner contract Purchaser
Lessee Other (explain )
4 . Parcel Identification: Zoning Map Sheet# I P Parcel#40 _,
zoning District(s) (include overl s)
Street Address
Required
5. EXistinq Proposed -by Zonin
Use of Structure/Property
(if project is only interior wo k, skip to #6)
Building height
%Bldg. Coverage (Footprint)
Setbacks - front
- side L: R: L: R
- rear
Lot size
Frontage.
Floor Area Ratio
oOpen Space (Lot area minus
building and parking)
Parking Spaces
Loading
Signs
Fill (volume & location)
6 . Narrative Description of Proposed Work/Project: (Use additional sheets
if necessary)
7. Attached- Plans: Sketch Plan Site Plan
8 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
Date: ��—�&-- g1r Applicant's Signature. `
THIS SECTION FOR OFFICIAL USE ONLY:
V/ Approved as presented/based on information presented
Denied as presented--Reason:
ecial' Perm' ?and/or Site Plan Required:
F d 'ng Re i,r'e ' Variance Required:
S. gnat e f u�ld�n off___.___. __ ...__ - �� ate
NOTE: tssuance of a zoning permit does not relieve an applicant's burden to comply rritli all zoning roquIroments and obtain all required pormits
from tho Board of Hoaith, Consorvation Commission, Dopaarnont of Public Works and olhor applicablo permit granting authoridos.
4;0 City of Northampton REQUIRED INSPECTIONS
1. Footings and Walls
BUILDING DEPARTMENT 2. Structural Components in Place*
3. Complete Building*
No. 162 Office of the Building Inspector
Zoning Form No. 003979 Date 3/20/95 Fee $40 Check# 2680
Page, 17D Parcel 28 ,Zone URB Section 127 ❑ Yes ]a No
BUI]LDINGPERMIT
*Plumbing and Electrical Inspections required
THIS CERTII US THAT D.A. Williams before Building Inspections
has permission to Insulate, sheetrock 2nd floor bedroom - Inspection on Site—Foundations
situated on 63 Straw Ave. Inspection of Plumbing—Rough
provided that the person accepting this permit shall in every respect Inspection of Plumbing—Finish
conform to the terms of the application on file in this office, and to the Gas Inspection
provisions of the Statutes and the Ordinances relating to the Construction, Inspection of Wiring—Rough
Maintenance and Inspection of Buildings in the City of Northampton.
Any violation of any of the terms above noted is an immediate revocation Inspection of Wiring—Finish
of this permit Expires six months from date ofissuance,if not started. Building Inspection—Rough
Note:A certificate of occupancy will be issued by this office upon return Insulation Inspection
of this card signed by the Plumbing,Wiring and Building Inspectors.
Building Inspection—Finish
Smoke Detectors(Fire Department)
Other
. THIS CARD MUST BE DISPLAYED IN A CONSPICU US PLACE ON TIC PREMISES
.Certificate of Occupancy L4 -
g Inspector _ 2,61f(F t 5j](b